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Three years of organizing came down to a few minutes and a room of public health professionals voting with clickers.

The American Public Health Association (APHA) on Tuesday overwhelmingly approved a statement recognizing law enforcement violence as a public health issue. It was one of a dozen policy statements adopted at the organization’s annual conference, including another that opposes the separation of migrant families at the U.S.-Mexico border.

The vote at the organization’s annual meeting in San Diego is an important move for the nation’s most prominent public health organization, which has more than 25,000 members. It may galvanize new research that focuses on the root causes of law enforcement violence, encourage its members to think beyond issues such as police body or dashboard cameras, and lend added heft to community-based criminal justice reform efforts.

It’s not clear what happens next. But with many public health researchers trained to generate statistics, they could contribute scholarship and reverse the relative lack of good data about law enforcement violence, a dearth caused largely by a lack of law enforcement transparency. The Guardian’s “The Counted” database reported that 1,093 people were killed by police in the United States in 2016, and a Washington Post database has documented that at least 850 people have been shot and killed by police so far in 2018. 

APHA will now frame police violence as a health equity issue and support policies to track, reduce, and speak against law enforcement violence. As described in the press release, this will put APHA in a position to, among other things, call “on Congress to fund the National Institute of Justice and the Centers for Disease Control and Prevention to conduct research on the health consequences of law enforcement violence, with a particular focus on disproportionate burdens among people of color, people with disabilities or mental illness, people living in poverty, people experiencing homelessness, immigrant populations, and lesbian, gay, bisexual and transgender populations.”

The statement is the work of End Police Violence (EPV), a group of independent scholars, physicians, college professors, graduate students, and early-career public health professionals influenced by grassroots organizing by Black Lives Matter and others. In 2016, they pushed APHA’s policy-making body, the Governing Council, to adopt a policy statement reinforcing that law enforcement violence—including police shootings, harassment, and other forms of abuse—is an urgent concern for doctors, nurses, public health officials, and scholars alike. But it was good for only a year and required reintroduction to become a permanent APHA policy statement.

At the November 2017 APHA conference, EPV introduced a revised statement for consideration. As Dr. Cheryl Conner, a physician at a Veterans Administration hospital and one of the EPV organizers who co-wrote the initial piece, remembered it, “The hearing was positive. There were only two or three people who said anything negative about it. There were at least 30 or 40 people who spoke in favor of it.”

But the comment period was cut short by a surprise visit by Surgeon General Jerome Adams, and when the vote happened, about 65 percent of the council opted to not approve the statement permanently—for some, a shocking defeat given the generally supportive remarks during the public discussions APHA requires for such policy proposals.

“Some of the resistance wasn’t clear or transparent,” said Jade Rivera, another EPV co-author who’s on the San Francisco State University (SFSU) faculty. “There are people within the organization who are committed to this work and value health equity, and there are people within the organization who haven’t thought about this issue because these issues haven’t impacted the community they come from or work with. And there are also the people who hold the ‘thin blue line.’” 

And as an arm of government, public health departments and programs have a built-in, if not always active, connection with publicly funded law enforcement.

Recognizing how hard it is to shift people’s world views, the EPV organizers retooled. They doubled down on educating APHA members and emphasizing research about law enforcement violence’s harm. They spoke to colleagues in the caucuses and sections inside the organization. They responded to pages upon pages of comments about the statement, packing it with more evidence to show law enforcement violence and related stress harms not just those directly affected, but communities. They worked with non-APHA groups such as Critical Resistance and the California Coalition for Women Prisoners; other community groups in Chicago and Columbus, Ohio, read and contributed to the statement. More external entities ultimately endorsed the statement than did internal APHA groups.

This week, during APHA’s conference, EPV and allies sponsored a “shadow” health equity conference featuring scholars and advocates in a predominantly Mexican American neighborhood miles away from the conference site. Some APHA members flew in for one day just for the vote.

On Tuesday, the statement passed, carrying at least 85 percent of the votes.

Beyond research, EPV organizer and SFSU lecturer Liz Kroboth hopes that the statement can bolster campaigns like one in her area to audit the sheriff’s department in Alameda, California.

Jessica Roach, a Rewire.News contributor and director of the Columbus, Ohio-based reproductive justice nonprofit Restoring Our Own Through Transformation, watched Tuesday’s vote. She, too, had been involved with drafting and thinking through the policy statements. A day earlier, she had shared research about links between redlining, police violence, and infant mortality in Ohio. Pictured in her PowerPoint was 23-year-old Henry Green, fatally shot by police in the summer of 2016.

“First thing, I left the meeting and called his mother,” she said. “First thing when I get back, this statement is going in the hands” of local advocates and policymakers in Columbus.